Finite element simulations on delamination-induced local stress shielding effects on aseptic loosening behavior by bone remodeling

Interfacial damages (wear, delamination) and bone damage (remodeling, micro-cracks) can significantly affect the local bone deterioration and loosening of the acetabular cup. However, limited research has been conducted on both delamination and bone remodeling. This study aims to analyze the loosening behavior of an acetabular cup caused by the interaction of both interfacial damages and bone remodeling under different boundary conditions. A three-dimensional model of the acetabular cup was developed, and mechanically-induced remodeling behavior was implemented for the surrounding bone while the interfacial delamination between the cup and bone was modeled using the fracture mechanics approach. The delamination in the low initial bone mineral density (BMDs) cases encompasses almost the entire cup surface, which significantly affects the local bone remodeling process. The bone density near the top edge could be reduced to 20% in the lowest BMDs case which exaggerates the local strain accumulation and causes it to approach the micro-breaking limit. The loosening risk of the 45∘ fixation was reported in the low BMDs case which is a major limitation in conventional operation procedures for elderly patients. The interactive effect of the low BDMs, inclination angle, and loading amplitude can reduce the aseptic loosening life by half. This can be attributed to the amplified embedding of the acetabular cup caused by the delamination-induced reduction of the bone density. In future works, we aim to further consider anisotropic bone remodeling, microstructure of the bone, and delamination initiation behavior of surface coating.